1 / 13

Ave Maria 2013 Employee Benefits Summary

Ave Maria 2013 Employee Benefits Summary . Plans at a Glance. Enrollment Elections. Basic Coverage Provided to All Eligible Employees, Employer-Paid Benefits Core Dental Basic Life / AD&D Long Term Disability Short Term Disability Adoption. Optional / Contributory Coverage,

burke
Download Presentation

Ave Maria 2013 Employee Benefits Summary

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Ave Maria 2013Employee Benefits Summary

  2. Plans at a Glance Enrollment Elections Basic Coverage Provided to All Eligible Employees, Employer-Paid Benefits Core Dental Basic Life / AD&D Long Term Disability Short Term Disability Adoption Optional / Contributory Coverage, Employee-Paid Benefits Core Medical - Employer contributes to expense Medical Plan1 - Employer contributes to expense Medical Plan 2 - Employer contributes to expense Enhanced Dental - Employer contributes to expense Vision - Employer contributes to expense Optional Employee/Spouse/Dependent Life Flexible Spending Account Various AFLAC products

  3. Medical- Simply Blue PPO

  4. Delta Dental ENHANCED CORE PPO Premier Non- Dentist Dentist Network Deductible $50 Single / $150 family per benefit year (the deductible does not apply to diagnostic, Preventive or Orthodontic Services) Class 1 Benefits Preventive 100% 100% 100% Class II Benefits Basic Services 75% 75% 75% Class III Benefits Major 50% 50% 50% Class IV Benefits Orthodontic 50% 50% 50% Maximum Payment Annual Maximum $1,200 per Calendar Year Orthodontic Lifetime Maximum $1,500 per person PPO Premier Non-Network DentistDentistDentist N/A 100% 100 % 100% N/A N/A N/A N/A N/A N/A N/A N/A N/A $1000 per calendar year N/A

  5. Delta Dental PPO Pricing Example Delta Dental PPO dentistDelta Dental Premier dentistNon participating dentist To whom will check be sent? The dentist The dentist You How is payment calculated Payment is based on the Payment is based on the Payment is based on the amount in Delta Dental’s billed fee or Delta Dental’s billed fee or Delta Dental PPO Fee Schedule, Maximum Approved Fee, Nonparticipating Dentist whichever is less. whichever is less. Fee, whichever is less. Things to Consider Participating Dentists : Participating Dentists: Non participating Dentists Will fill out and submit claim forms Will fill out and submit claim forms Can charge you the Cannot balance bill you Cannot balance bill you difference between their will only charge you for your will only charge you for your fee and the amount Delta copayment and deductible. copayment and deductible. Dental pays. May ask you to pay full amount up front. May require you to submit claim forms. Payment Example Dentist’s billed fee $120 Dentist’s billed fee $120 Dentist’s billed Fee $120 PPO Fee Schedule amount $67 Maximum Approved Fee $102 Nonparticipating Fee $77 Delta Dental pays 75% Delta Dental pays 75% of the Delta Dental pays 75% of the of nonparticipating PPO Fee Schedule amount: $50.25 PPO Fee Schedule amount $76.5 Dentist’s fee $57.75 You Pay: $16.75 You Pay: $26.50 You Pay: $62.25 Delta Dental PPO dentist cannot charge Delta Dental Premier dentist cannot Because dentist does not you the $53 difference between Delta charge you the $18 difference between participate, you are re- Dental PPO Fee Schedule amount and Delta Dental’s Maximum Approved Fee responsible for the his/her billed fee. You only pay your and his/her billed fee. You only pay difference between Delta copayment. your copayment. Dental’s payment and the dentist’s billed fee.

  6. VSP Vision Benefits Summary In NetworkOut-of-Network Vision Exam$10 co-pay Up to $45 Frames$130 Allowance; 20% of the Up to $70 amount over your allowance Prescription Glasses Standard Plastic Lenses: $25 co-pay Single Vision Up to $30 Lined Bifocal Up to $50 Lined Trifocal Up to $65 Standard Polycarbonate Up to $55 (for dependent children) Lens Options: Standard Progressive Plastics $55 co-pay Contact VSP if you are seeking Premium Progressive Plastics $95-$105 co-pay an out of network provider for Custom Progressive Plastics $150-$175 co-pay coverage amounts. Contact Lenses (instead of Glasses) $130 allowance Up to a $60 co-pay for your Up to $105 contact lens exam (fitting and evaluation) Laser Vision Correction 15% off retail price or 5% off N/A promotional price Frequency Examinations Once every 12 months Frames Once every 24 months Lenses or Contacts (in lieu of plastic lenses) Once every 12 months

  7. Life and AD&D Insurance Basic Life / AD&D (Cigna) Basic Life The Basic Life benefit is payable to your beneficiary should you die from most causes. The amount of coverage is : 1 x annual earnings to a maximum of $500,000. Amounts of Basic Life coverage in excess if $400,000 are subject to Evidence of Insurability rules. Accidental Death and Dismemberment The amount of AD&D coverage is: an additional 1 x base annual earnings to a maximum of $500,000. Benefit Reduction Schedule Benefit amount reduces to 65% at age 70, and 50% at age 75

  8. Voluntary Life Insurance Voluntary or Optional Life (Cigna) You have the opportunity to purchase additional Life insurance coverage under an optional program. This coverage is available for you, your spouse, and children at group rates. Amounts of coverage beyond the “guaranteed issue amount”, as well as subsequent purchases or coverage increases, are subject to Evidence of Insurability (EOI) rules. Employee: 1, 2, 3, 4, or 5 x base annual earnings to a maximum of $200,000 Guaranteed Issue amount = $200,000 (upon initial first eligibility) Spouse: $10,000 Child(ren): $5,000 per child Birth to 14 days: $500 15 days to 6 months: $2,000 6 months to 19 years $5,000 Any employee who currently participates in Voluntary Life, with Unum, and has a life volume over and above $200,000 will be “grandfathered” at that amount under the new Cigna Plan.

  9. Disability Insurance The plan provides eligible employees with short and long-term disability income benefits, and pays the full cost of this coverage. In the event you become disabled from a non work-related injury or sickness, disability income benefits are provided as a source of income. You are not eligible to receive short-term disability benefits if you are receiving workers’ compensation benefits. Short Term Disability (Verus Health) Benefit A short-term, non-occupational, illness or injury, although not necessarily serious, can still prevent you from working for a period of time. Should this happen, the Short Term Disability plan (STD) will replace a portion of your lost income. The amount of coverage is: 66.67% of Weekly Earnings Maximum Weekly Benefit = $750 Benefits become payable on the: 1st Calendar Day for Accident 8th Calendar Day for Sickness For a duration up to 26 Weeks Long Term Disability (Cigna) Benefit Long Term Disability is designed to continue to replace a portion of your income after your short term disability benefits are exhausted. It pays a benefit each month, for as long as you remain totally or partially disabled (or your normal Social Security retirement age, if earlier). The amount of the insurance is: 60% of Monthly Earnings Maximum Monthly Benefit = $10,000 Elimination Period = 180 days

  10. Medical, Enhanced Dental and Vision deductions are taken out on a pre-tax basis Single $118.82 $51.40 $10.06 $16.46 $0 $1.45 EE +1 $241.73 $106.85 $24.15 $30.60 $0 $2.90 Family $346.80 $149.90 $29.18 $51.61 $0 $4.32 If you choose to waive medical or dental, your opt-out benefit will be $15.00 per person per pay for medical and $2.50 per person per pay for dental Bi-weekly Cost for each $1,000 of Employee Voluntary Life Insurance Coverage Age <30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Rate $.02 $.03 $.04 $.06 $.10 $.15 $.23 $.37 $.67 $.96 $2.05 Spouse and Children – Flat $1.11 per family regardless of the number of children You must submit Evidence of Insurability on any amount of core life insurance over $400,000. If you waived Voluntary Life at your initial eligibility period you are considered a Late Entrant and are also subject to Evidence of Insurability. In addition, all subsequent requests for increased amounts of coverage will always require Evidence of Insurability. Payroll deductions will not begin until approval from the insurance company for amounts of coverage subject to Evidence of Insurability rules. MedicalDelta DentalVSPVision Plan 1Plan 2Core PlanEnhanced Core Contribution Schedule

  11. Additional Information • Ave Maria Human Resources Website • www.avemariahr.org(Employee Orientation → Open Enrollment 2013) • Verus Health Website • www.verushealth.com(Member & Provider Login) • Contact Verus Health for user name and password information • Due to changes in dental and vision plans, all employees are required to complete enrollment for 2013

  12. QUESTIONS?

More Related